Managing Stress and Distress

Distress—a mix of anxiety and depressive symptoms—may cause sleeplessness, lack of appetite, trouble concentrating and difficulty carrying on regular activities. Although some distress is normal, about a third of cancer patients experience significant distress. Only about five percent of those with cancer obtain psychological help. While distress doesn't affect the cancer itself, it does affect how patients cope with their cancer and their ability to follow treatment recommendations.

The NCCN Distress Thermometer and Problem List for Patients measures distress in a similar way to pain – on a scale of zero to 10, 10 being the worst. The NCCN Problem list allows patients to inform their doctor if they are having concerns in areas such as practical, family, emotional, spiritual, and physical problems. Often, emotional side effects of cancer are not discussed in as much detail as the physical side effects. This tool makes it easier for people to talk to their doctors about the emotional effects caused by the diagnosis, symptoms, and treatment of cancer.

Patients are encouraged to complete the NCCN Distress Thermometer and Problem List for Patients as part of their routine appointment preparation.